Liatsou Efstathia, Kollias Ioannis, Trapali Maria, Tsilimigras Diamantis I, Gavriatopoulou Maria, Ntanasis-Stathopoulos Ioannis
CAST, Center of Allogenic Transplantation and Cell Therapies, Karolinska University, 17177 Stockholm, Sweden.
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Cancers (Basel). 2025 Mar 8;17(6):927. doi: 10.3390/cancers17060927.
Liquid biopsies provide a less-invasive option to tissue biopsies for the early diagnosis, prognosis, and tailored therapy of colorectal cancer (CRC). CRC is a major cause of cancer-related death, and early identification is essential for improving patient outcomes.
Conventional diagnostic techniques, including colonoscopy and tissue biopsy, may be enhanced by liquid biopsies that examine circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), extracellular vesicles (EVs), and other indicators present in body fluids. These markers provide significant insights into tumor biology, heterogeneity, and therapeutic response. CTCs detected in early-stage CRC have prognostic significance for disease recurrence and survival, while ctDNA investigation may uncover genetic mutations, epigenetic alterations, and tumor development. The identification of ctDNA in minimal residual disease (MRD) postsurgery correlates with an elevated risk of recurrence and unfavorable prognosis, underscoring its use in assessing treatment effectiveness. Furthermore, non-coding RNAs (ncRNAs) contained inside EVs provide potential prospective biomarkers and therapeutic targets, facilitating diagnosis and treatment assessment. Notwithstanding the potential of liquid biopsies, obstacles persist in assay standardization, sensitivity enhancement, and the management of tumor heterogeneity. Additional extensive research is required to determine their function in clinical practice.
Overall, liquid biopsies serve as a potential instrument for real-time monitoring, evaluating therapy responses, and directing individualized therapeutic strategies in CRC patients.
液体活检为结直肠癌（CRC）的早期诊断、预后评估和个性化治疗提供了一种侵入性较小的替代组织活检的方法。CRC是癌症相关死亡的主要原因，早期识别对于改善患者预后至关重要。
传统诊断技术，包括结肠镜检查和组织活检，可能会通过液体活检得到增强，液体活检可检测循环肿瘤细胞（CTC）、循环肿瘤DNA（ctDNA）、细胞外囊泡（EV）以及体液中存在的其他指标。这些标志物为肿瘤生物学、异质性和治疗反应提供了重要见解。在早期CRC中检测到的CTC对疾病复发和生存具有预后意义，而对ctDNA的研究可能会发现基因突变、表观遗传改变和肿瘤发展情况。术后微小残留病（MRD）中ctDNA的识别与复发风险升高和不良预后相关，这突出了其在评估治疗效果方面的应用。此外，EV中包含的非编码RNA（ncRNA）提供了潜在的前瞻性生物标志物和治疗靶点，有助于诊断和治疗评估。尽管液体活检具有潜力，但在检测标准化、灵敏度提高和肿瘤异质性管理方面仍然存在障碍。需要进行更多广泛的研究来确定它们在临床实践中的作用。
总体而言，液体活检可作为一种潜在工具，用于对CRC患者进行实时监测、评估治疗反应和指导个性化治疗策略制定。
